Project Summary Case Western Reserve University School of Medicine (CWRU SOM) has provided integrated MD-PhD training since 1956 with many distinguished alumni, including two Nobel laureates. The NIH-funded CWRU Medical Scientist Training Program (MSTP) was started in 1975 (T32 GM07250) and has 107 current students. Research and clinical training occurs at CWRU and affiliated institutions (University Hospitals Cleveland Medical Center, Cleveland Clinic, MetroHealth Medical Center and the Louis Stokes Veteran?s Administration Medical Center). These sites are well equipped for cutting edge research and state of the art clinical training. The CWRU MSTP curriculum integrates scientific and clinical instruction in all three phases: both PhD and MD course work during the first two years, substantial personalized clinical instruction as well as research during the PhD years, and clinical clerkships, clinical electives and research electives in the final phase. PhD mentors provide individualized research training. Active mentors are well supported by NIH research grants or other funding sources; they also have established research training track records or, in the case of Initial Mentors, will be paired with a Senior Mentor to insure effective mentoring of trainees and to develop the mentoring skills of new trainers. Criteria for acceptance of MSTP students include superior academic performance and evidence of strong commitment and skills for research. Acceptance by the MSTP automatically admits a student to the SOM and any of the 14 MSTP-affiliated PhD programs. All CWRU MSTP students receive full financial support for stipend, tuition and health fees for all phases of the program (8.3 years mean duration), and the program provides laptop computers and travel awards for students to attend national research meetings. Numerous MSTP-specific program activities supplement the PhD and MD curricula. The program emphasizes development of leadership skills through student governance, faculty mentoring, and student-led program activities.